Louisiana Revised Statutes 46:153 – Medical assistance; estate recovery program
Terms Used In Louisiana Revised Statutes 46:153
- Charity: An agency, institution, or organization in existence and operating for the benefit of an indefinite number of persons and conducted for educational, religious, scientific, medical, or other beneficent purposes.
- Department: means the Department of Children and Family Services or the Louisiana Department of Health. See Louisiana Revised Statutes 46:1
- Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
- Indigent: means any person who meets the state definition of indigent who would have qualified for indigent care in any general hospital owned and operated by the state of Louisiana prior to arrest and who is housed in any parish or municipal jail or detention facility or state prison, shall be treated in the nearest general hospital owned and operated by the state of Louisiana. See Louisiana Revised Statutes 46:17
- Recipient: means the person who has received assistance under this Title. See Louisiana Revised Statutes 46:1
A. Medical assistance in the form of payment for medical care, including medical insurance in advance of the medical care, to the extent and under such conditions as federal matching funds can be obtained under the provisions of the federal Social Security Act, may be provided under rules and regulations of the Louisiana Department of Health to any person who:
(1) Meets the requirements for public assistance, or
(2) Does not meet the requirements for public assistance, but whose income and resources are not sufficient to meet his medical needs, and
(a) Is a resident of the state, or
(b) A resident of the state needing medical care as may be required or permitted under the provisions of the federal Social Security Act for federal matching purposes.
B. All certifications of eligibility for hospital care, either in a public or a private hospital or for any type of medical vendor payments by the department, shall be subject to the provisions in the first and fourth paragraphs of La. Rev. Stat. 46:56.
C. Except to the extent that the responsibility for payment for medical care of certain persons is transferred to the department in Subsection A of this Section and the pertinent rules and regulations subsequently adopted, the care and treatment of medically indigent persons shall remain the responsibility of the various charity hospitals of this state as provided by existing law.
D. The responsibility for payment for medical and hospital care, as provided in this Section, shall remain in effect until such time as any or all of these responsibilities shall be vested by law in some other agency of the state or federal government.
E. By applying for, and subsequently becoming eligible to receive, or by accepting medical assistance under provisions of this Section, the applicant or recipient shall be deemed to have made an assignment to the department of his right to any hospitalization, accident, medical, or health benefits owed to applicant or recipient by any third party, as well as rights to such benefits or medical support payments owed by any third party to applicant’s or recipient’s children or any other person for whom applicant or recipient has legal authority to execute such an assignment.
F. The Louisiana Department of Health shall implement an expedited Medicaid eligibility review program for persons diagnosed as having acquired immune deficiency syndrome (AIDS). If a preliminary review indicates a preponderance of evidence for presumptive Medicaid eligibility, then full, temporary Medicaid coverage for the person with AIDS shall be extended immediately and shall continue until such time as the final Medicaid application either is denied or until permanent eligibility is established and full, permanent coverage commences. If a final determination of ineligibility is made, the person with AIDS shall reimburse the department for funds expended on his behalf by the department during the period of temporary Medicaid coverage. The department shall promulgate rules as necessary for the implementation of this Subsection.
G. Repealed by Acts 2003, No. 226, §2.
H. The Louisiana Department of Health shall not lose its rights to recover the assistance payments and medical expenses the department has paid or is obligated to pay on behalf of an injured, ill, or deceased person in connection with said injury, illness, or death if the department does not intervene or file its own cause of action or take any other action allowed pursuant to the assignment of rights provision of Subsection E of this Section, or La. Rev. Stat. 46:446.
Added by Acts 1961, No. 16, §1. Amended by Acts 1966, No. 9, §1; Acts 1978, No. 786, §6, eff. July 17, 1978; Acts 1980, No. 255, §1; Acts 1988, No. 674, §1; Acts 1995, No. 1190, §1; Acts 1999, No. 1118, §1; Acts 2003, No. 226, §2; Acts 2003, No. 1208, §1; Acts 2018, No. 206, §5.